Objective: to verify what are the popular practices used for otalgia and cleaning of the external auditory canal. Methodology: qualitative research conducted by interviewing people known in their cities for having knowledge about popular practices, who recognized at least one practice used for earache; 54 people were interviewed. The applied questionnaire contained socio-demographic issues related to cleaning practices and ear pain. Results: most of the people interviewed (53.70%) are between 40 and 59 years old; 92.59% stated that they use informed practices; the main motivations for the application of the practices are the practicality of doing it, the low cost, as well as the easy access to the products used. The cotton swab was the main object used to clean the external auditory canal; and most practices are administered with heated components. Conclusion: the use of popular practices for ear pain is widespread in society, verifying that their use occurs in high frequency compared to the drugs used in current medicine

BACKGROUND AND OBJECTIVES:Allodynia is a pain induced by stimuli which normally do not induce pain; it is caused by changes in sensory specificity. Acupuncture may be used for neuropathic pains such as allodynia or hyperalgesia. However, most studies in this area are in animal models. This study aimed at reporting the first case of efficacy of the association of acupuncture and amitriptyline in human being with tactile ear allodynia.CASE REPORT:Female patient, 46 years old, complaining of paroxysmal pain, in shock, triggered by touch on the right concha of the ear, irradiating to ipsilateral fundus, as a consequence of epidermoid carcinoma excision in cranial posterior fossa six years ago. Other sequelae of such surgery were right central facial paralysis and left hemiparesis; however they were not her current complaint. Previously, paroxysmal pain had been only partially controlled with amitriptyline, being patient then referred for tentative treatment with acupuncture. Two acupuncture points were selected by the manual technique, together with the maintenance of previous amitriptyline. There has been pain decrease, being that at fifth consultation patient has withdrawn the use of amitriptyline on her own. Pain had totally regressed after the seventh consultation.CONCLUSION:Acupuncture was effective to treat allodynia, with no symptoms recurrence even after six months without intervention or drug use. For being the first report of this association in human beings, specifically for allodynia, further studies are needed.

This study quantified by, electrovibratography, the amount of mandible protrusion required to decrease significantly temporomandibular joint (TMJ) vibratory energy as an aid in the diagnosis of the recapture of anteriorly displaced disk. Eighteen patients diagnosed as having anterior disk displacement with reduction and TMJ clicking were submitted to electrovibratographic examination at the first appointment and treated with a stabilizing appliance and anterior positioning appliance with 1 to 5 mm protrusion. Vibratory energy was checked in each of these positions. Baseline data were used as control. At the first appointment, the patients had vibrations with more elevated intensities at the middle and late phases of the mouth opening cycle. At only one clinical step, mandible protrusion was obtained with the anterior repositioning appliance, ranging from 1 to 5 mm protusion. At each new position, a new electrovibratographic exam was made. After the 5-mm mandibular projection, only 2 patients presented vibration, with means between 0.6 and 2.8 Hz. Data were analyzed statistically by ANOVA and Tukey's test (α=0.05). The outcomes of this study indicate that 3 mm is the minimum amount of mandible protrusion to significantly decrease the TMJ vibratory energy and to recapture the displaced articular disk.

Because nonespecific symptoms and signs are associated with others well-established in the temporomandibular disorders, it is difficult for the clinician to decide what symptoms and signs should be considered during the diagnosis and the treatment plan. Therefore, the aim of this literature review was to evaluate the prevalence of aural symptoms (otalgias, tinnitus, dizziness and deafness) in patients with orofacial pain. Although several hypotheses have been proposed to explain the association between aural symptoms and temporomandibular disorders, the results of the previous studies differed in magnitude. For this reason, it is difficult to establish the prevalence of these aural symptoms concomitantly with temporomandibular disorders. Moreover, such relationship does not necessarily imply a cause-effect relationship. Because of the diagnosis complexity, different treatments must be considered, so the nonespecific symptoms of temporomandibular disorders can be effectively controlled as well. It is crucial for the the clinician to be aware of the possible etiology of aural symptoms, so he should determine if such symptoms may be associated with temporomandibular disorders and thus include them in the treatment.

A CASE REPORT OF RAMSAY HUNT SYNDROME Although earache is a common symptom in General practice, this case report aims to alert the reader to a rare cause of earache. The Ramsay Hunt syndrome is a rare complication of herpes zoster infection. Its clinical features are peripheral facial paralysis and vesicular lesions of the ear or mouth. We report the case of a woman who came to a consultation with her family doctor with a three day history of a burning sensation in her right ear. The following day she had a right-sided facial paralysis and vesicular lesions in the right ear. The diagnosis of Ramsay Hunt syndrome was made. Ramsay Hunt syndrome is the second most common cause of non-traumatic peripheral facial paralysis. The diagnosis is clinical and is made in the presence of pain, vesicular lesions, lacrimation, nasal congestion, salivation and peripheral facial paralysis. The main complications are encephalitis, myelitis and cranial and peripheral nerve palsies. The largest retrospective study published to date showed benefit from early treatment with acyclovir and prednisolone. The prognosis is good and 75% of all patients have a full recovery in one week.